Provider Demographics
NPI:1922564228
Name:LYNOTT, JACQUELIN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JACQUELIN
Middle Name:
Last Name:LYNOTT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W CHURCH ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7813
Mailing Address - Country:US
Mailing Address - Phone:443-431-0372
Mailing Address - Fax:240-324-8856
Practice Address - Street 1:120 W CHURCH ST STE 3A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7813
Practice Address - Country:US
Practice Address - Phone:443-431-0372
Practice Address - Fax:240-324-8856
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD246321041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical